Obesity and Health Risk of Children in the Mississippi Delta

• Published in: The Journal of school health 2012-10, Vol.82 (10), p.478-483
• Main Authors: Gamble, Abigail, Waddell, Dwight, Allison Ford, M., Bentley, John P., Woodyard, Catherine D., Hallam, Jeffrey S.
• Format: Article
• Language: English
• Subjects: African Americans - statistics & numerical data; Anthropometry; At Risk Persons; Body Composition; Body Mass Index; Body Weight; Child; Childhood obesity; Children; Childrens health; Chronic Disease - ethnology; Comorbidity; Cross-Sectional Studies; Dietary Services - legislation & jurisprudence; Education and state; Education policy; Elementary Education; Elementary School Students; Elementary Schools; Evaluation; Female; Government regulation; Health policy; Health Policy - legislation & jurisprudence; Health Promotion; Health risks; Health Status Disparities; Humans; Incidence; Laws, regulations and rules; Male; Measures (Individuals); Medical policy; Mississippi; Mississippi - epidemiology; Motor Activity; Nursing; Nutrition education; Obese children; Obesity; Obesity - complications; Obesity - ethnology; Obesity - prevention & control; Obesity in children; Physical education; Prevalence; Prevention; Risk Assessment; Risk factors; school health policy; School Policy; Schools - legislation & jurisprudence; Scientific Concepts; Social Class; State laws; Statistical Analysis; Surveys; Tukeys Test; Waist Circumference; waist-to-height ratio
• ISSN: 0022-4391; 1746-1561
• DOI: 10.1111/j.1746-1561.2012.00725.x

BACKGROUND: Mississippi (MS) Delta adults and youth report obesity rates far exceeding those of the state and nation. State law requires in‐school physical activity and nutrition practices to address childhood obesity but does not require evaluation of outcomes, specifically the impact on weight‐related outcomes. This paper offers 3 things: (1) describes the weight status of elementary school‐age children in the MS Delta; (2) explains the importance of including waist‐to‐height ratio (WHtR) values when reporting body mass index (BMI); and (3) provides impetus for policy that requires weight‐related health risk, as measured by WHtR, to be assessed regularly as a means to evaluate school health policy. METHODS: We took anthropometric measures in a cross‐sectional investigation of 1136 children from 11 public elementary schools in the MS Delta. Measures included BMI, waist circumference (WC) and WHtR. RESULTS: The prevalence of overweight and obesity (BMI ≥85th percentile) was 47.1% (18.3% overweight and 28.8% obese). In this sample, 59.9% and 42.0% were “at risk” for weight‐related chronic disease based on WC (≥75th percentile) and WHtR (>0.5), respectively. The differences in these proportions were statistically significant. The predominantly black districts reported higher on all of the weight‐related measures. CONCLUSIONS: Investigators recommend the assessment of health policy include measures of health risk in addition to BMI, namely WHtR as it accounts for growth in both WC and height over age. Furthermore, WHtR is a more accurate indicator of fat distribution and health risk than WC alone.